what is mycophenolate?
reuces thiopurien synthesis, leadign to slevetive inhibition of DNA replication in T and B cells, metabolsied to mycophenolate acid which ahs a more selective mode of action than azathiopurines
what are side effects and monitoring requirements of mycophenolate?
bone marrow suppression, increased risk of infection, gastro-intestinal disorders, skin disorders/ photosensitivity/ increased susceptibility to skin cancer
monitoring: FBC, weekly for 4 weeks, then bi monthly for 2 months then monthly first year . powerful teratogen, MHRA advices 2 preganancy tests before treatemtn initiation
what si the MHRA risk ?
Available clinical evidence does not indicate an increased risk of malformations or miscarriage in pregnancies where the father was taking mycophenolate medicines, however mycophenolate mofetil and mycophenolic acid are genotoxic and a risk cannot be fully excluded;
what are counselling points?
- use spf
- use effective contraception - male ad female
- comply with pregaancy preevntion advice
- look out for symptoms of myelosuppression - mouth ucelr,s unexplaiend bleedign or brusiign etc, infections,
